Thursday, 2 September 2010

Junior Doctors

What he wants out of supervision is, most meaningfully to him, being equipped to pass his exams. Without that, his career is thwarted and he can't progress his training to become a Consultant Psychiatrist.

What the Royal College wants out of supervision is unrealistic, with a full lever arch file failing to contain all that's meant to be covered, but in essence there's an expectation that all elements of the GMC's Good Medical Practice and all core generic medical competencies and old age psychiatry will be delivered. Most meaningfully to the RCPsych is progress of the curriculum (evidenced in doctor's portfolio and online workplace based assessments).

What the Trust wants is a safe practitioner doing appropriate work so, most meaningful to the Trust, is a supervised practitioner who's learnt and is fully aware and using in their practice the hundreds of Trust policies we have.

What the patients want of him isn't really factored in.

What I want is different and diverse and aspirational. In 3 or 4 years, my junior doctor is likely to be a Consultant Psychiatrist. What should such a junior doctor be mentored, informed or developed in, through ongoing weekly supervision?

Perspective. The single most valuable thing a mentor can offer is the ability to critically analyse one's progress through life, and an example of how they themselves live a full and varied one. If you can convince him/her to take some of that hour to focus on their overall development, you will have engendered skills that will last far past the exams coming in the next few years.

Secondarily, if you were my supervisor, I'd like to see enthusiasm. The process of undertaking training can sap one's love of one's job. Finding my supervisor every week still enjoying his job would be reassuring and reinvigorating, as I'd know I had similar to look forward to.

As to content, I'm sure it's the easiest aspect, what with that lever arch file ;)

For some of our junior doctors there is a tendency for the online bureaucracy to impede rather than facilitate good training which is very sad. There are too many boxes to tick and the software is a struggle. Boxes and online systems are favoured by those in charge because they produce lots of data which give the illusion of training. There is also a view that weaknesses can be rectified by a courses rather than by real experience as an apprentice.

Why Lake Cocytus?

Dante's "Inferno" takes us on a journey through to the deepest layer of Hell, passing down through layers of fire. Within this Ninth Layer there is no flame, there is a lake of ice. Imprisoned within this are the those of greatest evil, those of greatest betrayal. Rather a puzzle to me, this one. Is it a terrible place, manifesting evil incarnate? Or is Lake Cocytus a good thing, containing the world's greatest evils?

Good or evil this place, this Lake Cocytus, is my space to entomb the thoughts and musings best interred in ice.

"Because love is not sex or a shared faith, or the 'joint maintenance of a household and the upbringing of children'."
- Sergei Lukyanenko

"Look at that. Look at that. "Accident Blackspot"? These aren't accidents. They're throwing themselves into the road gladly. Throwing themselves into the road to escape all this hideousness."
- Withnail & I

"We know what happens to people who stay in the middle of the road. They get run down."
- Aneurin Bevan